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tv   U.S. Senate Debates Deputy Interior Secretary Nomination  CSPAN  July 24, 2017 10:00pm-11:21pm EDT

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this is about an eight- or nine-hour drive from her house. when her teeth got so bad and so painful after her firing and needed to have had her teeth pulled, she didn't have anybody to do it. she said i think there is a free clinic in appalachia. it's a couple months out so i'm going to have to suffer through the pain for awhile. i also have to save up some money. she saved up her money like most people would save money for a summer vacation. she saved up her money so she could put enough gas in her car so she could drive for nine hours to wise county, virginia, and come and get a bench of her teeth pulled, in the richest and most compassionate nation on earth. and finally, i had another guy, and i asked him the question you ask, what are you here for? are you here for medical services? are you here for dental services? are you here for vision services? and he said, well, i'm actually here for all three, but the problem is it's the hottest day
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of the year, it's 95 and humid, and i can't sit out in the sun -- i'm so circumi can't sit out in the -- i'm so sick, i can't sit out in the sunday all. i've got to do two of the three. and i said, which are the worst? he said, look, i'll do dental and i'll do medical. but even though i've grat got glasses, i can't wait around, i can't wait around because i'm so sick out in the hot sun, you're just going to have to give me the two of the three. i can't wait all day. in this dusty fairground on the 21 ost of july to get health care. these people need us to be at our best. they need us to be thinking about them. the first time i went to this clinic in weiss, i was struck by
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the magnitude of the need. but the thing that really hit me was when i went in the parking lot and i expected to see cars from virginia and kentucky -- kentucky is ten miles away from this fair ground, and i might have expected to see cars from west virginia, or tennessee, but north carolina is 150 miles away and south carolina is 350 miles away and georgia is 400 miles away, and alabama is farther and oklahoma is farther, and people drive from all over the southeast united states in the richest nation on earth in the most compassionate nation on earth to wait for days in a dusty campground in the heat of the hottest part of the summer so that they can have their teeth pulled, because they don't have health care. the affordable care act has cut the un-insurance rate to one of the lowest in recorded history, but we haven't gone far enough. we've got to do better by these people who are sleeping in their cars or up against chain-linked
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fences, who are traveling for nine hours to get their teeth pulled -- not worse. we want to have fewer people like this and fewer folks who need to do this not more. and the vote that we're going to have about whether it's 22 million or 25 million or 32 million people who lose health insurance, that's going the wrong way. we got to go a different way. we've got to do better, not worse. most of the things we talk about in this chamber, they are about issues. this isn't about issues. this is about who we are. this is about who we are as senators. this is about who we are as americans. this is about who we are as thinking, feeling, breathing, believing hemobeings. it's about -- human beings. it's about who we are. a great teacher, a great teacher once laid out the art -- i was
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sick and you took care of them me. that's one version of the new testament. there's another phraseologies. i was sick and you visited me. i was sick and you cared for me. i was sick and you looked after me. the teacher basically says, the way you treat someone who is sick is the way you treat the creator. it's important to be compassionate to somebody who's sick, and anybody who's hearing these words, you don't have to think for a second to think about somebody in your family who is suffering from cancer or dementia or mental illness or who's been the victim an accident -- the victim of an accident. there are faces appearing in your minds right now because we all have this in our family. the way we treat people who are sick is not just a measure of us, it's a measure of what we think about the creator.
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when a great teach said, i was sick and you took care of me, he was giving an instruction to us about the way we should behave. in the last week i'm struck by fact that this body has been jolted by the news about two of our colleagues, both of whom who have had cancer diagnoses. last week we were shocked and saddened to hear about our colleague from arizona, senator mccain, who is my chairman on the armed services committee. he is suffering a very tough form of cancer and cancer is going to find a match in a senator mccain. this touches us in this body. a week two before we heard about another colleague on the armed services committee who sits next to me at every hearing, senator hirono who indicated she had kidney cancer. she is shea a strong, she's a
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fighter, just like senator mccain. but she's worried about it just like senator mccain would be. this touches everyone. it touches the powerful, it touches the powerless. it touches the wealthy, it touches the poor. it touches men, it touches women. it touches the young, it touches the old. it touches everyone. and the way we treat people who are sick, the way we treat people who are anxious about their health is the way we treat the creator. that's what we are taught. so let's live up to that standard. why would we do otherwise? why are we here? why did we run? why do we serve? what do people expect of us? i was sick, and you cared for me. i was sick, and you visited me. i was sick, and you looked after me. i was sick, and you took care of me.
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is it that hard? is it so important to rush it through and not have hearings and not have committees and not engage the democrats and not listen to the people sleeping against chain-linked fences or driving nine hours to get their teeth pulled? we can't afford to get this wrong. and the talent of the people in this body convinces me beyond a shadow of a doubt that if we take the time, we can get this right. and if we can get this right, why won't we take the time to get this right? so i would plead with my colleagues, let's stand together on behalf of the sick. let's stand together on behalf of those who are counting on us. another part of the new testament is the letter of paul to the heroes. because we're surrounded by such a great cloud of witnesses, we've got to do the right thing.
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we are surrounded by a great cloud of witnesses who want us to do the right thing. and i know we can. and i pray that we will. and with that, mr. president, i yield the floor. mr. murphy: mr. president? the presiding officer: the senator from connecticut. mr. murphy: thank you, mr. president. i'm really glad that i was able to be here on the floor to hear the remarks of my great friend, senator kaine. it is gut check time in the united states senate. the legislation that we're going
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to consider tomorrow, it would hurt a lot of people in ways i think that are very hard to fathom. one of our colleagues said, i didn't come here to hurt people. everybody came here with designs on how to make their community, their state, their nation a better place. and we are on the verge of taking a vote on a bill that objectively will rain a level of devastation down on this country that's really hard to fathom. i can't match senator kaine's eloquence talking about the personal stakes here. we take for granted the fact that, as employees of the united states senate, we get a health benefit that makes sure that if we do fall ill or if our children fall ill, we won't have to think about whether or not we
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have the money to be able to afford treatment. but that's not how it is for all of those families that lined up in virginia to receive care. that's not how it is for those that come to a similar event in connecticut that's targeted just for dental services, but has a line that begins the night before and is oversubscribed before the event beginnings the next morning. -- the vent begins the next morning. and that's not how it is for millions of american families that used to go bankrupt because when phrased between a choice of -- when faced between a choice of personal financial ruin and the death after child who are a loved one, they chose financial ruin. and until you have been faced with that choice, i don't think there is any way to understand it. it's certainly a choice that no one in this chamber will ever
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have to make. but in connecticut the burger family made that choice. before the affordable care act was passed, in the two-week period of time where mr. burger didn't have health care insurance, their son was diagnosed with cancer, and when he got on his new plan, it was a preexisting condition, so it wasn't covered, and the burger family lost everything. they went through their savings account. they lost their house. but they went bankrupt, and they were one of thousands and thousands of families who made that choice. that rarely happens any longer. the number of personal bankruptcies in this country have been cut in half because of the affordable care act. the affordable care act hasn't made health care magically affordable for everyone, but it has meant that people don't have to make that choice any longer.
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the scope of the pain that we're talking about -- if any of the three versions of that bill get a vote -- really is hard to fathom. under the original version of the bill, 23 million people would lose insurance. now, i amended this chart when a series of changes were made at the last minute that c.b.o. scored as reducing that number to 22 million. but that is the entire population of alaska, delaware, hawaii, idaho, kansas, maine, montana, nebraska, nevada, new hampshire, new mexico, north dakota, south dakota, and west virginia -- all losing health care at the same time. and the majority of that happens in the first year. so of the 22 million, 14 million or 15 million of those people lose insurance next year. the scope of that devastation, 12 months from now, 15 million
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less people have insurance, 15 million more people showing up to emergency rooms to get care, is something that i don't think any of my colleagues really can get their head wrapped around. and for all the times that president trump says that the affordable health care act is dead, that obamacare? a death spiral, that's -- that obamacare is in a death spiral, that's just not true. it is a lie. it's a lie. because the congressional budget office says that the death spiral only occurs if you pass any of the versions of the legislation that we're considering. that if the affordable care act stays in place, 28 million people won't have insurance, which is far too many, but if one of these bills goes into effect at the end of ten years you'll have 50 million people without insurance. a new report from the kaiser
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family foundation found that the a.c.a. markets are not collapsing. despite what the white house says, despite the lies that they perpetuate. quote, early results from 2017 suggest the individual market is stabilizing and insurers in this market are regaining profitability. quote, insurer financial results show no sign of a market collapse. that's the kaiser family foundation's finding, which mirrors the findings of c.b.o. the collapse in our insurance markets only happens if one of these bills pass. and i.t. not just the -- and it's not just the number of people who lose health care. the folks that we should care most about, people that are making just enough money so they don't qualify for federal programs but not enough money
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that they can save for retirement and pay for their kids' college bills and do all the things you need to do in order to lead a respectable life, those people are going to be hurt the worst by this bill. if you're a 64-year-old getting ready for medicare coverage, you're making $56,000 a year, you're going to pay 170% more under this bill just in your premiums. never mind the extra money you're going to pay in co-pays and deductibles. c.b.o. says that if these bills are passed, a single policyholder purchasing a plan at a 58% actuarial value in 2006 would have a deductible of roughly $13,000 for drugs and medical expenses combined which is absolutely unaffordable.
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and so by every metric, whether it be the amount of money you pay or the number of people that don't have health care coverage, c.b.o. answers this question, who gets hurt under the g.o.p. health care plan, pretty clearly. everybody, unless your insurance company, drug company or the rich. if you're affluent and can afford your own health care you'll be fine. if you're an insurance company or drug company you'll get a big tax break out of this but everyone else gets hurt and gets hurt really bad. i've watched my republican friends process this information. i've watched them largely stay silent. democrats are the only people on the floor of the senate these days talking about health care. most of my republican friends are not willing to come down and defend any of these products. but those that have been have shifted their rationale. republicans who have been willing to come down and defend
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their plan, they concede that millions and millions of people will lose insurance. they concede that rates will go up for most americans. and so they cling to one last value that underpins the republican health care plan. in their words, that value is freedom, the freedom not to be insured. and so republicans suggest that you shouldn't really worry about 32 million people losing insurance because those people really didn't want insurance. and now they'll be free not to have it. that's just not what c.b.o. says. c.b.o. says that millions and millions of these people who will lose insurance, they desperately want it. they're just not going to be able to afford it. and it's also not true that the bill grants that kind of
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freedom. insurance is compulsory under the republican health care plan, just like it is under the democratic plan. it's just compulsory in a different way. the republican plan says that as a penalty for not having insurance, you will be banned from purchasing insurance for six months. the affordable care act says if you don't purchase insurance you will get a penalty on your tax form. either way it's a penalty. but a new wrinkle has been thrown into this debate because last week it was ruled that under reconciliation the republicans can't include this provision, this penalty provision. and without it, the entire bill falls apart. markets would collapse. for all of republicans' talk
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about the freedom not to purchase insurance, they included a requirement that people buy insurance in their bill. and they know that they had to. because they know that without it, the entire insurance market would collapse. why is that? well, if you require insurance companies to charge the same thing for sick people as for nonsick people, then you have to encourage people who aren't sick to buy insurance. because if you don't folks will wait until they're sick to buy insurance and the only people who will have insurance are people who have acute conditions. that will make insurance itself unaffordable and insurers will stop offering products or jack up the rate to the price it is totally unaffordable for everyone. in the affordable care act, that is what led to the individual mandate. in the republican health care bill, that is what led to this
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provision that locks you out of insurance for six months. but that has been ruled veritable. that is has been ruled essentially out of order under reconciliation. and so republicans are going to be faced with a choice if they are able to get on to this bill. they will either remove that provision and guarantee the collapse of the entire insurance market in this country. or they will have to strengthen that penalty in order for it to be allowed under reconciliation. but that essentially robs the last rhetorical argument that republicans had in favor of this bill. they can't argue that it provides more people with insurance. they cannot argue that it helps with costs. they cannot claim that it increases quality. they know that. the only thing left that they could argue is that it allows some people to go without insurance if they don't want it.
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but in truth, their bill didn't do that. and the rules of the senate are going to require that they increase that penalty even more if they want any plausible, workable version of this bill to survive. and so it leaves us in a place where there is no argument to do this. it doesn't advance values that republicans hold dear like personal freedom. it doesn't improve people's health care experiences. it doesn't increase the number of people who have health care insurance. and it really does beg the question, are why are we doing this? did anybody come to the senate with the desire to hurt this many people? if i had told my republican colleagues four years ago that
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your a.c.a. replacement plan was going to drive up the number of people without insurance by 32 million and increase rates by 20% in year one, would you have believed it? no. i took for six years, my republican colleagues at their word. i didn't agree with them that we should repeal the affordable care act but i at least thought they had the same goals in mind as we did. more people having access to the health care system. costs being controlled for as many people as possible. it's now clear that we don't. republicans are about to vote on a bill that will inflict really unthinkable amounts of pain on this country. who gets hurt under the g.o.p. health plan? everybody. and i said this on the floor last week, and i'll just say it
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again to close, it doesn't have to be this way. we've accepted for so long that health care is a political ping-pong ball that gets tossed from one side to the other every five or ten years. why is it so in conceivable that democrats and republicans couldn't sit down together and try to work out keeping the parts of the affordable care act that are working and improving the parts that aren't? why couldn't democrats understand that republicans want the flexibility of benefit design and give republicans something on that? if you understood that we want some certainty in these marketplaces, we don't want president trump to be able to sabotage and undermine these markets, why can't there be a compromise and a deal there? there's still time.
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if this vote fails tomorrow, there's still the ability for us to come together. in the end that story that senator kaine tells about rural virginia, everybody here knows that story. everybody here knows that there is still enormous work still to be done. and nobody out there is believing the lies about this bill, this wonderful health care plan that president trump is promising. everybody in this country hates this bill. it's got a 15% approval rating. these folks know there is virtually no one who is helped by this bill other than insurance companies, drug companies and people who are very affluent and fortunate enough to be healthy. we don't have a communicable disease on our side of the aisle. we're not going to physically hurt you if you get in a room with us.
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we actually do deeply desire to improve the health care system. you just got to give us a chance. i yield the floor.
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a senator: mr. president. the presiding officer: the senator from oregon. a senator: are we under a quorum call? the presiding officer: we are not. mr. merkley: mr. president, i rise now to address the republican plan to have a vote on a health care bill, proceeding to a health care bill tomorrow. the only challenge is that we have no idea what bill we're being asked to proceed to. this is hardly the way a
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democratic republic operates in which the leader of the majority says we want to come to the floor with no committee deliberation, no consultation with health care experts, no dialogue with the public, no amendments in committee of any kind, and vote on a mystery bill. the biggest mystery to me is how it is possible that the majority republicans are taking seriously a plan to rip health care from 20 million-plus americans in order to give fabulous giveaways to the richest among us. the bill that they entertained previously would have given $33 billion to the richest 400 americans. $33 billion. i mentioned this number before. some journalists have said,
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quoted it as 33 million and some citizens have said you mean 33,000? no. $33 billion to the richest 400 americans. enough funds to pay for medicaid for 700,000 people. what individual would say it's moral to rip health care away from 20 million people to give tax breaks to the very richest among us? well, some misguided, mysterious way something has gotten hold of the hearts and minds of my colleagues and made them think this was some kind of good idea to do so much damage to so many. in fact, we've been having this conversation since january. it was earlier this year when president trump was sworn in that the majority said we're going to come to the floor of the senate, and we're going to repeal health care for millions
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of americans in short order. we're six months later. it hasn't happened yet in part because when people look at the details they start to raise questions. and it took a long time for the house to send a bill over to the senate. and then the senate proceeded to work on this bill with a group of 13 secret senators, working in a secret room, in secret meetings, public not allowed, fellow senators not allowed and they came up with a bill that looks very much like the house bill. we'll talk more about that later. the president said in his campaign and throughout much of this year, you're going to have such great health care at a tiny fraction of the cost. and it's going to be so easy. well, it hasn't been that easy. we've seen the president back a
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plan from the house. he invited everyone over to celebrate at the white house and get the champagne bottles out and say how wonderful it was that the house had passed this health care bill, this bill that would strip health care from more than 20 million americans. then a couple weeks later someone explained to him what was in that bill. he said, oh, well that bill is mean and heartless, and then the secret 13 here in the senate meet and they come out with a very similar bill, and now he's all excited. trump is all excited. now we have a really good bill, except that in a single year it would do even more damage to health care in america. along the way, the president moderated his dialogue a bit and he said, who knew health care
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could be so complicated? well, mr. president, most of the people in america realize we have a complicated health care system. we have overlapping system of six different systems of health care. it's really -- it real lay is quite messy and -- it really is quite messy and difficult. and it would be great if we could adopt a much simpler system. and i certainly have been advocating for us to have a much simpler system. so just by the right of being an american, air born into this -- you're born into this world and you have health care. that's the way most developed nations do it. but not here in the united states of america. we have a great health care system for the very wealthy, and we have a very complicated, stressful system for everyone else. what are we going to vote on tomorrow? i wish the majority leader would
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come to the floor and tell us. a motion to proceed to a bill that looks like what? what can you tell us? is it trumpcare 3.0? how did it differ from trumpcare 1.0 or 2.0? will it have the cruz amendment in it for fake insurance, the insurance -- the provision that would do enormous damage at both ends of the insurance market, providing fake insurance policies to the young and the healthy and destabilizing health care and putting it into a death spiral for everyone else. or, mr. majority leader, maybe you could come and tell us if you're planing a straight repeal of the a.c.a. a straight repeal that would raise costs and premiums even higher and not just rip health care from 20-plus million people but 30-plus million people.
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a plan that would be even more devastating than the previous plan. is that what you want us to vote on to proceed to tomorrow? i can tell you, we shouldn't be voting to proceed to any versi version, on health care, something that so affects the peace of mind and the quality of life of americans. we should be operating like a democracy, like a democratic republic, holding committee hearings, holding a conversation. this is what we did when we talked about the a.c.a. those several years ago. we had more than 100 committee meetings, roundtables, and walkthroughs here in the u.s. senate. we had the single-longest markup of a health care bill in the help committee ever in the history of the united states. we had the second longest session marking unthe bill in the finance committee -- marking up the bill in the finance committee. we had hundreds and hundreds of
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amendments, adopted over 100 republican amendments. it was a very public extended process with a ton of time to go home and consult with your health care experts and stakeholders in your own state and with the most important stakeholders, the citizens of the united states of america, the men and women and sons and daughters and grandparents and how did they feel about these changes. with as everyone knows -- well, as everyone knows, president trump did call the house bill mean and heartless, but we just keep getting bills that are meaner and more heartless. where the house bill would kick 23 million people off insurance? the next decade -- of of insurance the next decade and 13 million just next year, the subsequent bills don't look that different. the secret 13 here in the senate went and did their
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deliberations, adopted pretty much the same thing as the senate, only they made it worse. that june senate bill would kick 15 million off in a single year rather than 14 million. and then we had the brilliant idea of a repeal-only bill, which would do even worse, kicking 17 million people off in a single year and 32 million off within the ten-year period. and then we have the bill that isn't even on here because we didn't get a congressional budget office score on it. that is the special cruz fake insurance amendment bill, the one that would say, hey, insurance companies, you can offer policies that are not worth the paper they're written on. oh, they're very appealing. there is a health insurance policy. you only have to pay $40 a month. isn't that great? and then the policyholder who has it, they get in a car
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accident. they get a broken bone. they find out the emergency room is not covered. the x-rays are not covered. the cast is not covered. the doctor is not covered. nothing is covered. that's why it's fake insurance. that's why it only costs $40 a month. it might as well be 40 cents a month for all we care because it just doesn't cover anything. and then your spouse, your wife has the great, joyful news that you're going to have a child together. and, guess what? maternity care is not covered. can you imagine in this modern era not covering maternity care? and yet before in the affordable care act, many, many policies in america didn't -- and yet before the affordable care act, many, many policies in america didn't cover maternity care. well, in addition, these brilliant plans by my colleagues would cause premiums to
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skyrocket. then we have, of course, the fact that they do diabolical things to those who have preexisting conditions. now, let me spend a little more time on the special cruz fake insurance version of this. yes, it gave those very cheap policies that aren't worth the paper they're printed on to the young and the healthy, but then those who are older, those who are sick or have injuries or have preexisting conditions or are concerned that they may develop difficult medical issues, they need to buy a policy that actually covers the things that you would expect, that has an essential benefits package, the same as every single policy in america today has. and -- but because the young and the healthy are buying the fake policies, that means that the cost skyrockets on the policies
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with the essential care benefits. and as a result of that, more people bail out who feel like they're not directly in danger of getting sicker or injured, and so then the cost of the policy goes up even more. it is a death spiral for insurance. fake insurance at one end, destruction of the insurance market at the other end. so my colleagues decided not even to share the congressional budget office analysis of that bill. it was that bad. let's see what some folks said about this. larry leavitt, the senior vice president of the kaiser family foundation said, and i quote, if there were a joy of cooking for insurance, this would be the perfect recipe for destabilizing the market and turning the marketplaces into high-risk pools. that's his comment about the
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cruz fake insurance plan. and let's turn to a joint letter from blue cross blue shield and from america's health insurance plans about the cruz insurance plan, the cruz fake insurance plan. and i quote, their letter says, it is simply unworkable in any form and would undermine protections for those with preexisting medical conditions, kress premiums, and lead to widespread for people currently enrolled in the individual market. or how about an article in the "atlantic" by ben newkirk, published just a weeing a, july h--- a week ago, just 14 of year. the cruz amendment creates almost a textbook scenario of
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wide scale adverse selection whereby riskier and more expensive patients wind up concentrated in risk pools and entirely undermines any tools for managing that adverse selection. that's a fancy way of talking about the death spiral in insurance for those who are not young and healthy. so then we go to the conversation that c.b.o. says is the worst option of all -- 17 million would lose coverage in the first year and 32 million by 2026 under the repeal-only plan, and next year in just one year premiums would skyrocket above what they might have gone to anyway by an additional 25%. now, our majority leader likes to say that wouldn't actually happen because of provisions of the bill don't go into effect for two years.
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well, these estimates and these commentaries take that into account because the destabilization of the marketplace begins immediately. does anyone really think insurance companies are going to stick around a marketplace that they don't know is going to exist in one or two years? this repeal-and-run strategy would throw our health care industry into chaos. if you think it's a good plan, well, i've got some beachfront property in arizona you might want to buy. every version of this republican trumpcare plan is worse and worse for the american people. yet these are the options that are being put forward. the majority leader want us to vote to proceed to this set of
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undesirables tomorrow, these undesirable -- in fact, undesirable is just too kind word for these kind of policies. these are despicable. these are destructive. these are, as the president said, mean and hard-hearted. shouldn't we try to pursue options that will make our health care system work better? that's what we need to do. and let's start by nailing down the cost-sharing reduction payments, or c.s.r.'s. these payments are a lifeline to more than 12 million low-income americans. they lower the premiums and they lower the deductibles. they're an important source of stability for insurance companies. but our president has said, i'm not sure i want to release these c.s.r. payments, so what happens with that? insurance companies have to assume they're not going to get
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them, so they're raising their rates or perhaps bailing out of the market completely. if these c.s.r. payments are terminated, insurers may leave these exchanges altogether. and for those who do stay in the average premiums for silver plans would need to increase by 19% just to compensate for the loss of the c.s.r.'s. because insurance companies are like any other business, they need to know how much they're going to be paid if they provide a product. and right now they don't know. let's hear what some have had to say. when anthem, an insurance company called anthem pulled out of ohio in june last month, the company cited, quote, continual changes in federal operations, rules, and guidance as the main
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-- guidance as the main reason for exiting the marketplace. the company also said, and i quote, the individual market remains volatile and the lack of certainty of funding for cost-sharing reductions does not provide a sustainable path forward. then there's brad wilson be, the president of blue cross blue shield of north carolina, who said, the biggest single reason for that rate increase is the lack of federal funding for cost-sharing reduction payments in 2018. we cannot assume, nor should we, that the money is going to be there based on what we know today. at another point, mr. wilson was quoted as saying, the failure of the administration and the house to bring certainty and clarity by funding c.s.r.' r.'s has caud our company to file a 22.9% premium increase, rather than one that is materially lower.
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the rate increase would be 8.8% if the c.s.r. ... they have to go with a higher increase because they don't know if the president is going to make the payments that he's obliged to make. but i think a piece of the baltimore sun from may 5 describes the situation we find ourselves in best when it says, quote, it's not the problems in the affordable care act exchanges that are driving the republican effort to repeal obamacare. it's the republican effort to kill obamacare that's causing the problem in the exchanges. it goes on to say that the affordable care act was carefully designed to mitigate those risks. president trump and the congressional republicans are trying to exacerbate them, and he closes by saying no wonder
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rates are going up. this is really -- this really does make clear the situation. the president wants to save -- say the exchanges have problems, so we need to repeal and run or repeal and replace. our answer to the exchanges having problems is to drive 20-million people plus off health care, maybe 30 million people off health care. but in fact the exchanges are having problems because they're being sabotaged by president trump and our republican colleagues. first, by wiping out the reinsurance proposal which enables companies to go into a new area and compete, but only if they have insurance against getting a disproportionate share of the really sick people. that's a very logical part of an insurance plan that encourages companies to go into new markets, compete and our colleagues sabotaged it. cost sharing reduction payments
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we just talked about, a very key part of lowering premiums and making the policies affordable so that struggling, hardworking americans can buy those policies and have lower premiums and lower deductibles. but my colleagues and president trump have sabotaged it. that is not a service to the american people. maybe they feel they're doing a service to who? to the rich who can buy insurance without any of this effort to provide insurance throughout our society? do my colleagues really want a world in which we only have wealth care? that is health care that only the wealthy can buy. do they really want to denigrate, tear down and destroy the quality of life of millions of their constituents by pursuing this path?
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it's not that long ago that franklin roosevelt said the test of our progress is not whether we have more of an abundance of those who have much but whether we do enough for those who have little. but in their bills, my colleagues have been saying we want to give massive tax giveaways to those who have the most by ripping health care away from those who are struggling, hardworking americans. it's the opposite. it's the opposite of the belief that we're all in this together and we want a foundation for every family to thrive. i want a foundation for every family to thrive, and that means peace of mind that if your loved one gets sick, that they will get the care that they need. it's a peace of mind that if your loved one gets sick they won't end up bankrupt. we're not just talking about ripping health care insurance away from more than 20 million people. we're talking about ripping
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peace of mind away from 20 million people. and we're not just talking about those individuals. we're talking about undermining the rural and urban health care infrastructure that helps everyone. i've been out in very rural republican parts of my state holding town halls. and what i'm hearing is from those who are in clinics, and they have improved considerably. some of them have doubled their number of employees over the last eight years because of the support for health care clinics in the a.c.a. and also because of uncompensated care. that is the number of people who couldn't pay their bills have dropped enormously. not only are they able to employ a lot more people providing health care in the community but they have been able to do additional things. they have been able to provide
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more preventive services, more mental health services and forth. it's been a big win for rural america, and my colleagues want to tear that down. and that just doesn't make any sense at all. and it's why everyone here should vote unanimously to oppose getting on to a mystery health care bill tomorrow. there's so much we could do together if we want to improve health care. fix those c.s.r.'s, provide to fix the reinsurance, proceed to have a full enrollment period rather than cutting it short, retain and reinforce the individual mandates so that those who have insurance are covered throughout the spectrum from the young and healthy to those who are older. provide the sort of advertisement that enables people to sign up and make the
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signup process a lot easier than it is right now. there's so much we can do together to make our health care system work better. my colleagues have come to the floor tonight to say this really matters. quit playing games with people's lives. quit trying to destroy the foundation for our families to thrive and vote no on a motion to proceed to a mystery health care bill tomorrow. thank you, mr. president. and i yield the floor. a senator: mr. president. the presiding officer: the senator from hawaii. mr. schatz: thank you, mr. president. the senate republicans are about to take one of the most reckless actions in senate history. they're going to vote to blow up the american health care system and do i don't know what next. and i want to be really clear
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about this. never before has the senate voted on major legislation that would reorder one-sixth of the american economy and impact tens of millions of american families without even knowing what the bill does. there has been no bipartisanship. there have been no hearings. and let me just say something about hearings. this may seem like sort of a process foul, a procedural complaint. but this very much matters. hearings matters because it's how you get experts to tell you whether your bill is any good, whether it's smart or stupid, harmful or helpful. hearings matter because they subject your bill and the process to public scrutiny. the media is able to report on what you're up to, and your constituents know what you're up to. and so it's not a small thing to complain about no hearings. in fact, you can't be a good
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legislator without having hearings. and you can't be an effective legislative body without conducting public hearings. we never have major legislation without hearings, but that's exactly what they are doing. and there's one very simple reason for this. they are embarrassed by what is in this bill. now it's true that we don't know exactly what's in this bill. there are lots and lots of versions and lots of sort of notions being kicked around. but we can be sure of a few things. first, we know this. whatever problems there are with the affordable care act, this bill doesn't even bother to try to fix that. to the extent that people are worried about high deductibles, it actually increases deductibles. to the extent that people are worried about the lack of choices on the health care exchanges, it doesn't even try to fix that.
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second, wye don't know -- we don't know exactly how much they're going to cut medicaid, but they are going to cut medicaid, whether it's rolling back the medicaid expansion or making these radical structural reforms essentially block granting medicaid to the states. they are going to deeply cut medicaid. and this hurts people. this hurts people in nursing homes. it hurts people with drug addiction. medicaid is a program that works and delivers care for millions of americans, and it will be slashed massively tomorrow. and so we don't also know whether they're going to keep the capital gains tax cut or get rid of it. in any case they are going to get rid of most of the revenue in the affordable care act. they are cutting taxes for the very wealthy and the way they pay for that is to cut medicaid. and so under the guise of fixing the a.c.a., they do the thing
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that they wanted to do all along: cut taxes, cut medicaid. it's got nothing to do with a.c.a. cut taxes, cut medicaid, that's what the bill tomorrow will do. i don't care if it's the 2015 version, i don't care if it is bcra, the cruz version. all of this stuff cuts taxes for the wealthy and cuts medicaid. that's what this legislation does. americans are going to be hurt by this legislation. people with preexisting conditions, a family with a loved one struggling with opioid abuse. people in nursing homes. people who rely on medicaid. people who rely on planned parenthood. the tens of millions of people who will lose their insurance almost instantly. and that's why every single patient advocacy group from the american cancer society to the march of dimes to the national physicians alliance to disability groups to the aarp,
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everybody hates this bill. and make no mistake, they hate every version of it. it's not like there is a less harmful version. 22 million lose their health care or 23 million lose their health care or 32 million lose their health care. we don't have to do this to ourselves. we don't have to do this to the american people. so there are lots of different versions of this legislation, and what the leader is doing very cleverly is to allow people to believe that the thing they're moving to is the thing that they may prefer. so, in other words, it's a blank canvas. it's just a motion to proceed. it's just a motion to begin debate. but make no mistake, the vote tomorrow is a vote to repeal the affordable care act with no plan to replace it. that's what they're doing tomorrow. and they have been totally secretive because they know the moment they start talking specifics, the whole thing comes crashing down.
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there are core elements of this vote tomorrow that are true no matter what. it cuts medicaid. it cuts taxes for the rich. it reduces patient protections. it reduces the number of people who have insurance. and it will all be done with no hearings, no democrats, no experts on health care. this thing will be dropped on us without enough time to review it, without enough time to interact with our home state to figure out what the impact will be. we're being asked to do one of the most reckless things any group of legislators have ever been asked to do, which is to jump off a policy cliff, a health care cliff, a political cliff. and eventually they're going to tell you it's going to work out. make no mistake, the reason they can't tell you what's in the bill is the moment that they do, this thing will come crashing down. and so what we have to do is make sure that this thing comes crashing down anyway. we have to do it for the tens of
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millions of americans who depend on medicaid and the a.c.a. we have to do it for rural hospitals, we have to do it for people with preexisting conditions, we have to do it for people without power, without money, without the ability to walk 200 yards from this chamber to the united states senate doctor, the best health care in the world. not only are we on the exchange -- i have a kaiser plan. we're on the exchange. we're in a.c.a. but also any time we want, i got a headache, a stomach ache, something more serious. i can walk literally about 200 yards from here and go to the senate doctor and get whatever kind of health care i need. and so i want you to understand how lucky the people who are voting on your future are and how privileged we all are in this literally gilded place, where people's lives and livelihoods and life savings are on the line tomorrow. and if i get so much as a
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hangnail, i get to call my staff and have them help me out. we are lucky people, and we need to think about who we are representing. i will be fine. every member of this chamber will be fine. but our job is not to take care of ourselves. our job is to represent our constituents. and this bill has earned a really historic title. most unpopular major bill in american history, most unpopular major bill in american history. how that can get 20 votes let alone 51 is beyond me. and i want to make one last point. we need to kill this bill not just because of all the harm that it's going to do to the country. we need to do it for the legislative branch of the united states government. we just can't make laws like
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this. right now the majority party is shortsighted because at some point democrats are going to have the gavels, and the temptation to follow this precedent being set this week, to enact major legislation without hearings and without the other party, might destroy the senate itself. there is still time. there is still good will. we can walk back from the brink and dot right thing. -- and do the right thing. i yield the floor.
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a senator: mr. president? the presiding officer: the senator from georgia. mr. perdue: mr. president, it is nice to see you here at 11:00 p.m. montana day night. it is one of the privileges we have of being a majority, that we get to preside over the united states senate. so we get to listen to all of our colleagues talk here to this august body. but i've been in that chamber for the last couple of hours, mr. president, and i can't go to bed tonight without putting this record straight in this body. i don't think there's a member of this united states senate that doesn't want america to have the best health care in the world. the problem is, we have a campaign of disinformation that's under way right now, mr. president, and it is outrageous. and i cannot let it stand.
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my mission tonight, very briefly, will be to put some facts on the table, on the record, because we have a lot of innuendo right now, a lot of disinformation. oh, my god, people are going to die. well, let me remind everybody, we're sitting here with a health care system that's collapsing. there is no other way to describe t but why are we here tonight at 11:00 p.m.? before we get to health care reform i want to remind the american people why the united states national is open tonight. we also did this earlier in the spring, because something historic is under way right now in the united states of america. and that is this: for the first time in our history, the minority party has not waived a rule that would bypass the time requirements put in the rules of the senate when confirming a nominee by the president of the united states. and because of that, we to date have only confirmed something around 29% of this president's nominees, mr. president. now, the prior president at this very point in time had over 70%
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-- over 70%, almost 300 people. i think the number today is under 50, mr. president, for this president. it wasn't until a monthing a he could have a constitutional -- it wasn't until a month ago that he could have a full staff meeting. and who's running this government today? holdovers from the last administration. over 200 people now standing in line waiting to be confirmed by this body. it is outrageous. the american people ought to be upset. but let's define who is doing that, not the majority party, the minority party is dragging its feet because it slows down everything else. guess what else doesn't get done this year, mr. president, if we continue with this schedule, unless we're in here every night, like we are tonight, we won't have time to get to taxes this year, we won't have time to get to what the american people are assuming we're going to get to. consumer confidence is at a 13-year high because they're
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anticipating we're going to clean up some of this mess. let me move ton health care real quick and try to put a few facts in the record tonight before we close. there are five health care systems in america that we -- we forget this. we only talk about obamacare right now, but there are five health care systems in america. first, we have group policies. this is where almost -- well, the vast majority are in this. anybody who works in a company or in a large organization has a group policy, mr. president. then there's the individual market. the individual market is what obamacare addresses. but it's only 13% of the entire health care system. only 13%. then there's the v.a. then there's medicare and medicaid. five different systems of health care in the united states. what we're dealing with is the individual market and medicaid, mostly the individual market, mr. president. but let me try to describe the situation as we see it today. in 2008 before the a.c.a. there
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were 48 million people in america who did not have insurance. that's a catastrophe by anybody's measure. the richest one in the history of the world, we had -- the richest country in the history of the world, we had 48 million people who did not have insurance. you could be precluded from having insurance because of a preexisting condition. you could lose your insurance. you couldn't transfer it across state lines, if you changed policies -- even if group policies, you could be denied insurance under the next insurer's policy. but today after the a.c.a., 28 million people as we stand here tonight still do not have insurance in america. 28 million. now, of the 20 million that got it, 16 million got it only because of the expansion of medicaid, not because of obamacare in the individual market. 16 million got it because of the expansion of medicaid. all that was was a bribery of the federal government to states who decided to take the money and run.
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they didn't do their citizens full justice. what we see now of the remaining million who got insurance, the remaining 4 million are 2 million like my wife and myself. mr. president, remember the day when president obama said, if you like your insurance you can keep your insurance? if you like your doctor you can keep your doctor? well, either -- like most democrats in the senate and the house who voted on obamacare without reading it, he obviously didn't know what was in the bill. because neither of those things were true. i was canceled. i now have -- before -- in an individual policy before i ran for the united states senate, mr. president, my individual policy as a retiree was canceled. and the only policy we could get under the exchanges in obamacare included things like vision, hearing, drug rehabilitation, mr. president -- i've never had a problem with that, my wife hasn't either -- and maternity. i met my wife in first grade.
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we're not having babies at this age. what is that? my rate has almost doubled because we had to take things in policies that we did not need. okay? of the remaining 2 million, 1 million are the most destitute, low-income people who really do need our help. but we've disrupted the entire health care system because we thought -- the democrats thought that bigger government approach would work. well, how has that worked out with places like the v.a.? you know, i hear talk now about single-payer. i a. get to that in -- i'll goat that in a second. if you like the v.a., you're going to love a single pay system because that's exactly what it is. let me go on, mr. president. i've heard a the love talk in this chamber tonight about -- i've heard a lot of talk in this chamber tonight about, oh, the republicans are going to hurt people in america. let me talk about who's hurting people in america today. in 23014 -- -- in 2014 -- this is a travesty itself. we cannot get the information from the i.r.s. we have just gotten the
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information from the i.r.s. in 2014, mr. president, the i.r.s., under the rules of obamacare, fined 8 million people $1.8 billion, mr. president. i don't know about you, but i'm outraged. i know you are, too. now, the uni-of that is -- now, the irony of that is that 85% of the people that were fined, $1 .8 billion, half of them made less than $25,000. so what our democratic friends s did is they crammed down the throat of americans this thing called obamacare and then put fines on people who couldn't afford insurance and they're the poorest people in our country. now who's standing for those guys today? the democrats? don't you bet. they want a big-government solution that gives them more power, and they could care less about the very poor people they claim to champion, mr. president. i've had enough of it. this is outrageous.
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22 million people are going to lose insurance. let's clean this up right now. the c.b.o.'s own estimate says that once you remove the mandate -- forget about what else is available -- if you just remove the mandate, because the policies are so expensive, 15 million are going to give it up. that's happening today. oh, by the way, you no he that c.b.o. was using a march 2016 baseline, mr. president? h., to compare these numbers to. it is just outrageous. in business you would never accept this. yet today they're determined to be the holy grail up here. i haven't seen a number come out of the c.b.o. that i would depend on yet. in 2010 they why yo overestimate number of people who would sign up for obamacare by 12 million people. they missed the estimate by more than 50%. this isn't a rounding error. they don't know what they're doing. right now today we have the same problem. 15 million they say will give their insurance up voluntarily because it is too expensive. that has nothing to do with the
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new plan. that's because obamacare is too expensive. they also say that 4 million would give up medicaid. why would somebody give medicaid up? they say obamacare is so good and so affordable that they're going to add 5 million people to it. there is no reason to believe that. there is no evidence to date that would back that claim. that is not a quantified model outcome. it is a person's estimate who sits overthrow and makes this up, mr. president, and we act -- the other side is acting like, oh, my goodness, this is the holy grail. let's talk about this. the premiums under obamacare prior to this year are up over 105% in america, and they say, well, the reason premiums are going up is because of uncertainty coming out of the white house. mr. president, this year's rates were determined last year before we even knew that this president was going to be a many no. -- going to be a nominee. another disinformation. what i'm fed up with, mr. president, is that it sounds like a good story until you see
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the facts. the premiums in my state alone going into next year are going up 42%. and here's the untold truth. in my state, 96 of 159 counties only have one carrier. that's a monopoly. they can do pretty much whatever they want. that's under obamacare, not anything else we're talking about, mr. president. that's the reality today. and oh, by the way, here's the real comeuppance. today in my state -- and you've got the staple problem in your state -- 300 -- and you've got the same problem in your state, 300,000 people cannot get insurance today under obamacare. forget about what we're talking about to fix this problem. today under obamacare they can't get insurance, 300,000 people in my state. and that's true in every state in our country. that's the untold ugliness of obamacare. obamacare is hurting people right now. i'm tired of hearing the other side talk about they care for people, they care for people and then they fine the poorest people in america $1.8 billion,
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mr. president. and then deny 300,000 people in my state access to health care. enough already. well, what are we doing about it? six months ago this president said there were four objectives that any insurance system had to do -- or had to meet. the first was access. we already talked about how obamacare is failing people who need access to it. the lowest-income people in america are being denied insurance today under obamacare. we fix that. people who want insurance are going to get insurance. and oh, by the way, premiums was the second thing we had to do to try to get costs down because it's becoming too prohibitively i have got sons in the middle of their career. they can't afford the insurance they're offered today. i feel it firsthand in my own life. premiums, right now, though, if we put into place the suggestions that we have on the table right now, h.h.s. department has just estimated last week with a very credible
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model that rates could come down as much as 78%, mr. president. in the next four years. has anybody heard the other side remind us of that data point? no. well, why do those rates come down? because the free market gets to act again. all of a sudden we move -- oh, by the way, they mawk talk about these made-up fantasy policies. i had one that you can't get today under obamacare. it is called catastrophic coverage. for some people with a high deductible and catastrophic coverage, that works. well, they're denied that today, mr. president, because big government knows more about what you need in your personal life. the third thing we had to do -- and this was very important. the second part of this problem is that medicaid was not on a sustainable path, mr. president. i'm sorry, they've overpromised and they cannot deliver. there is no way over the next 30 years we can sustain medicaid just like medicare and social
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security are going bankrupt, we cannot afford to do what they are promising people that we're going to and they know that. they already know that. just like the great society, mr. president. i mean, these big-government programs that they promise all the time are going to work have never worked. the great society, war on poverty was going to remove poverty from america, mr. president. i remember that. i set at a desk where that bill was signed by the then-democratic leader of the senate, richard russell before it went to the white house. i'm reminded every day about how big government has failed the american people. that war on poverty has spent trillions of dollars trying to reduce poverty in america and yet today the poverty rate is fundamentally the same it was in 1965 when that was signed into law. big government does not work in situations like this. i lived under a single-payer. my son lived under a single-payer. what single-payer does -- and this is the alternative they're off. i've heard it mentioned three times on the floor of the senate
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tonight. we cannot go there. it bifurcates deliver. it woulded would -- it would a2 trillion every single year. that's impossible. if you think that would work, imagine this. go home and look at your tax bill. whatever you pay the federal government last year, double it. that's what that would mean. that's what that would mean. double it it's not workable. the fourth thing we had to do was to make sure preexisting conditions were protected. i worried about that through my entire career, mr. president. when i changed jobs if i had been sick or my family had been sick, i might have been denied insurance. we cannot allow that, and this bill doesn't allow that. we have protected preexisting conditions. we have made -- put medicaid on a sustainable path for the long term. we also bring premiums down. that was a major priority here. and we give everybody in america access to health care, period, end of conversation. but that's not good enough.
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the other side is not going to be happy until this federal government steps in and takes over 18% of our economy called health care. if they try to do it in 1992 to 1994 under hillarycare. they tried to do it here. i remember the speaker of the house saying if you want to know what's in this bill, you have to vote for the bill. we are not doing that today. but this cloud of innuendo the other side has perpetrated on the american people, mr. president, is just not true. in 2010, not one republican voted for obamacare. not one amendment got to the floor of this senate. and yet, they want to talk about, oh, this great open policy. they have had seven years to fix this mess. seven years. the people in my state have been hurt by it. it's unforgivable, and we can do something about it this week. senator john mccain is very sick. he's a fighter. he'll take care of this. i hope he will be back this week to help us. if he can, i think he will.
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but we are going to vote on this this week, mr. president. we have got to do this for the american people. i want to remind everybody what's at stake here, though. if we don't pass this tomorrow, then we end up moving toward a singlepayer system, and let me remind everybody of the other big government failures we talk about. the v.a., the postal service, fannie mae and freddie mac are bankrupt. we talk about the obamacare failures and the great america's war on poverty. i want to remind everybody. let me just close with this. i have heard tonight this is a reckless action, the new policy. i have heard new testament examples of how to take care of your brethren, mr. president. it's shocking to me that somebody on the other side would say that when they know these statistics of what they have done. eight million poorest people in america have been fined $1.8 billion. half of them make under $25,000 a year. yeah, that's taking care of your
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brethren all right. i'm embarrassed. we can fix that. i believe -- we've heard the rain of devastation, no one is helped by this bill. it's a reckless act. here's the one i love. we want to work with you. we want to work with you to help fix this thing. just a year ago, mr. president, i didn't hear any speeches in here. i don't think you did either on that chair where anybody on your side even ook nodged there was anything wrong with obamacare. we're here to say we want to help you fix obamacare. it's seven years too late in my opinion. it would have been nice to have been included in the conversation in 2009 and 2010 when it was crammed down the throats of republicans. mr. president, i will close with this. i believe this is a historic moment in america. not just for health care. health care is very important, but it's bigger than that. this is about the direction of our country. are we going to try and trust big government again and again and again until we can't afford it? we are already well down that rabbit hole, mr. president. we cannot afford this chance again. we've already proven it doesn't
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work. so i hope this week that colleagues on our side will get together and we will vote this thing in. i welcome the democratic support as well. i know we're not going to get it. but this is a time to stand. i hope we will have that vote. i fully encourage my colleagues here to support that, and let's get on with business. thank you, mr. president. with that, i ask the senate stand adjourned under the previous order. the presiding officer: without objection. the senate stands adjourned until 12:00 noon tomorrow.
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